Promising Initial Results on Embolization for Tennis Elbow Presented at SIR 2019
March 24, 2019—Patients with lateral epicondylitis (or "tennis elbow") who have failed to improve with conservative treatments may benefit from transcatheter arterial embolization (TAE), according to results presented by Yuji Okuno, MD, PhD, at the Society of Interventional Radiology's (SIR) 2019 Annual Scientific Sessions in Austin, Texas.
Dr. Okuno and colleagues from the Okuno Clinic in Tokyo, Japan, who have pioneered early studies of embolization for musculoskeletal applications, shared midterm outcomes from a prospective study of 52 patients treated with TAE for tennis elbow between March 2013 and October 2017. Patients enrolled in the study were determined to have moderate to severe pain that was resistant to conservative therapies for more than 3 months and symptom duration beyond 6 months. Dr. Okuno reported that abnormal vessels were identified in all subjects. The operators used an imipenem/cilastatin sodium compound that forms a small, temporary particle to embolize abnormal blood flow.
Their findings include a significant decrease in Quick Disability of the Arm, Shoulder, and Hand scores at 1, 3, 6, and 24 months (52.1 at baseline vs 21.4, 8.2, 5.6, and 3.7, respectively; all P < .001), and there were statistically significant improvements in the last observed value in all evaluated clinical parameters and pain scores. Additionally, 2-year MRI follow-up was available in 32 patients; these evaluations showed improvement in tendinosis and tear scores. No patients were determined to have experienced adjacent complications such as bone marrow necrosis, obvious cartilage loss, or muscle atrophy.
“Tennis elbow can be difficult to treat, leaving many patients unable to perform the simplest tasks, such as picking up their children, cooking dinner, or even working on a computer. With this frustration, many patients turn to invasive major surgery after years of failed physical therapy and medication use,” said Dr. Okuno in an SIR announcement. “We were interested to see if this technique, already in use in other areas of the body, would be effective for this common debilitating condition and help people immediately regain a range of motion that many of us take for granted in our everyday tasks.”